Kornimate/medical-research-clean huggingface dataset:
obesity and mortality of critically ill patients with covid-19

Conditions: COVID; Severe Acute Respiratory Syndrome; Obesity; Comorbidities and Coexisting Conditions

Summary: disproportionate impact of covid-19 in patients with obesity is now well established. obesity is associated with severe forms of covid-19 and may be a risk factor of intensive care unit (icu) admission. obesity is associated with covid-19 related hospital death in a large united kingdom cohort study. however, there is a gap of knowledge on assessment of outcomes such as severity of acute respiratory distress syndrome (ards), duration of hospitalisation and mortality in icu. moreover, an obesity survival paradox has been observed in patients with ards. this raises the question whether the obesity paradox has been broken by covid-19. the investigators aim to explore risk factors of in-icu death for patient with covid-19, including obesity and other chronic diseases and to describe the clinical course and outcomes, including the management of acute respiratory failure and other intensive care management.

the investigators aim to report icu mortality for patients according to bmi category and to describe the detailed icu clinical course of illness : * risk factors for icu mortality : age, sex, baseline comorbidities * causes of death * risk factors for use of non invasive mechanical ventilation * non-fatal outcomes * ventilator-free days * icu length of stay.

Eligibility criteria:
inclusion criteria: * adult patients with covid-19 pneumonia admitted to icus between february 27th and april 18th 2020. * infection confirmed by reverse transcriptase polymerase chain reaction assay or radiologically by chest computed tomography scan exclusion criteria: * no weight or height measurement available in the medical files

Keywords: mortality covid-19 invasive mechanical ventilation obesity acute respiratory distress syndrome intensive care unit critically ill patient
oculocardiac reflex brain wave monitor

Conditions: Bradycardia; Strabismus

Summary: oculocardiac reflex during routine strabismus surgery was prospectively observed in association with routine brain wave monitoring. providence hospital institutional review board (irb) approved this observational study without need for consent.

introduction: the oculocardiac reflex (ocr), bradycardia that occurs during strabismus surgery, is blocked by anticholinergics and enhanced by opioids and dexmedetomidine. two recent studies suggest that deeper inhalational anesthesia monitored by bispectral index (bis) protects against ocr; the investigators wondered if our data correlated similarly. methods: in an ongoing, prospective study of ocr elicited by 10-second, 200 gram square-wave traction on extraocular muscles (eom) from 2009 to 2013, anesthetic depth was estimated in cohorts using either bis or narcotrend monitors. the depth of anesthesia was deliberately varied between first and second eom tested.

Eligibility criteria:
inclusion criteria: * all exclusion criteria: * those receiving anticholinergic medications
compassion-based intervention for lung cancer caregivers (cbi-lcc)

Conditions: Compassion

Summary: objectives: this 3-year study aims to develop, refine, and evaluate a brief compassion-based intervention specifically designed for family caregivers of lung cancer patients. in the first year, the primary focus will be on developing the intervention content and assessing its feasibility and acceptability. in the second and third years, the goal will be to assess the intervention's effects on depression and anxiety. method: in the first year, the intervention will be developed in three stages. initially, the intervention will be created based on compassion-focused theory and evidence-based exercises, incorporating feedback from family caregivers in previous studies and insights from professionals to ensure its relevance to lung cancer caregivers. next, a pilot study will test the intervention's feasibility and acceptability with 30 family caregivers, using mixed methods to gather session-by-session feedback and assess recruitment, retention, and adherence. following the pilot, the intervention will be revised based on participant and researcher feedback, preparing it for further study. in the second and third years, a randomized controlled trial (rct) will be conducted with 84 participants randomly assigned to either the 4-session brief compassion-based intervention (bci) or a single-session telephone-based support and education (tse) control group. outcomes, including depression, anxiety, caregiver stress, mindfulness, self-compassion, and self-efficacy, will be measured at baseline, immediately post-intervention, and at 3- and 6-month follow-ups. for data analysis, long-term follow-up quantitative data will be analyzed using the generalized estimating equation (gee) to examine group differences. moderation and mediation analyses will be conducted to explore potential moderators and mechanisms of the intervention. qualitative data from interviews will be analyzed using content analysis. expected results: this study is expected to provide a comprehensive understanding of the feasibility, acceptability, and effectiveness of compassion-based interventions for lung cancer caregivers, contributing to their application in clinical care practice.


Eligibility criteria:
inclusion criteria: * primary family caregiver of a person with newly diagnosed lung cancer (within one year of diagnosis) * aged 20 years or older * access to a computer or smartphone with internet connection at home exclusion criteria: * currently receiving psychological therapy * diagnosed with a severe mental illness and taking medication for it (e.g.,psychosis, bipolar disorder) * previous experience with mindfulness or self-compassion training

Keywords: compassion-based intervention lung cancer family caregivers caregiver stress depression anxiety mindfulness self-compassion
impact of vitamin d supplementation on cardiac structure and function

Conditions: Cardiovascular Disease

Summary: the vitamin d and omega-3 trial (vital; nct 01169259) is a randomized clinical trial in 20,000 u.s. men and women investigating whether taking daily dietary supplements of vitamin d3 (2000 iu) or fish oil (1 gram of omega-3 fatty acids) reduces the risk of developing cancer, heart disease, and stroke in people who do not have a prior history of these illnesses. this ancillary study (vital-echo) is being conducted among participants in vital and will examine whether vitamin d compared to placebo: (1) reduces left ventricular (lv) mass in elderly individuals as measured with 2-dimensional echocardiography and (2) improves lv systolic and diastolic function as measured with tissue doppler echocardiography.

recognition of the biological effects of vitamin d on cardiovascular function has been growing. the main objective of the parent trial (vital) is to evaluate the effects of vitamin d on cardiac events but is focused on atherothrombotic events and does not specifically address vitamin d effects on lv mass. in ambulatory individuals, lv mass is a key cardiac structural feature and increases in lv mass are frequently accompanied by diastolic dysfunction. this study leverages the existing infrastructure of the parent vital trial to perform cardiac imaging studies on a subset of subjects who will be randomized to vitamin d3 (n=500) or placebo (n=500). echocardiography is a noninvasive, widely accessible tool to evaluate cardiac structure and function. cardiac echo imaging visits will take place at baseline (pre-randomization), and then after 2 years, at the massachusetts general hospital (mgh). the acronym vital-echo reflects the link to the parent vital trial and an ancillary investigation of vitamin d versus placebo on lv mass and function as measured by echocardiography. the effect of fish oil supplementation on these parameters will be evaluated as a secondary endpoint, thereby taking advantage of the factorial design of the parent trial.

Eligibility criteria:
participants in vital (nct 01169259) who meet the following criteria are eligible to participate in this ancillary study: inclusion: * willingness to participate in ancillary study of vital to undergo cardiac echocardiography (baseline and at 3 years) and sign informed consent to participate in the ancillary study * live in the greater boston area (within 60 miles of mgh) exclusion: * have a pacemaker, prosthetic valve(s), surgical wires or other devices that could alter the echocardiographic image findings.

Keywords: vitamin d3 left ventricular mass echocardiography left ventricular systolic and diastolic function
optimization of antibiotic treatment in hematopoietic stem cell receptors

Conditions: Hematopoietic Stem Cell Transplantation; Graft Versus Host Disease

Summary: there are data suggesting that the reduction of the diversity of intestinal microbiota caused by the used treatments in the setting of allogeneic hemopoietic stem cell transplant (asct), and specially antibiotics, may be related to increased incidence of graft versus host disease (gvhd) and worst clinical outcomes. present "european conference on infections in leukaemia" guidelines exhort to antibiotic treatment optimization in hematological patients, without excluding asct receptors. this study aims to demonstrate that in asct receptors a predefined protocol of optimization of the antibacterial treatment will preserve the intestinal microbiota diversity which will correlate with decrease incidence of acute gvhd. and that this procedure is safe because it will not worsen the incidence of infections, transplant related mortality, infectious mortality or global survival.


Eligibility criteria:
inclusion criteria: * patients admitted to receive their first allogeneic hematopoietic transplant as a treatment of any disease. * conformity of the patient to participate by signing the informed consent. * patients who have received a previous autologous transplant are not excluded. exclusion criteria: * non-compliance of the patient to sign the informed consent. * patients who have already started the conditioning (or thereafter) will not be included. * allograft recipients who have previously received the transplant will not be included. second allogeneic transplants are excluded.

Keywords: microbiota microbiome graft versus host disease infection antibiotics
erector spinae plane blocks for adolescent idiopathic scoliosis

Conditions: Pain, Postoperative; Opioid Use; Recruitment

Summary: pediatric spinal fusion (psf) surgery is a painful procedure that can treat adolescent idiopathic scoliosis (ais). one technique that can potentially reduce patients' pain levels and need for opioid medication is the ultrasound-guided erector spinae plane block (espb). the esp block is a technique that involves injecting an anesthetic medication into the muscles of the lower back on both sides of the spine. previous studies have shown that espb application led to a reduction in opioid use, and there is one pediatric case report of espb use in two patients undergoing psf. however, there is still lack of evidence that the espb technique is feasible and effective in the pediatric patient population. the present study is designed to be the first randomized controlled trial to evaluate the role of espb in pediatric spinal fusion surgery and the role of espb within an enhanced recovery pathway.


Eligibility criteria:
inclusion criteria: * age 10-19 years old * patients undergoing multilevel posterior spinal instrumentation and fusion * undergoing surgery for correction of adolescent idiopathic scoliosis * patients under the care of participating surgeons * english speaking exclusion criteria: * patients younger than 10 years old or older than 19 years old * neuromuscular scoliosis * patient under the care of non-participating surgeon performing the procedure * history of chronic opioid therapy (longer than 4 weeks) to treat back pain attributed to scoliosis tolerance, as defined by centers for disease control (cdc) criteria (more than 60 oral morphine equivalents (ome) daily for over 2 weeks) * chronic pain conditions necessitating neuromodulating medications (gabapentin, pregabalin) * allergy, intolerance, or contraindication to any protocol component/study medication/technique * patient or parent refusal * non-english speaking
chemotherapy in treating patients with metastatic ewing's sarcoma or primitive neuroectodermal tumor

Conditions: Sarcoma

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. combining more than one drug may kill more tumor cells. purpose: phase ii trial to study the effectiveness of combination chemotherapy in treating patients who have metastatic ewing's sarcoma or primitive neuroectodermal tumor.

objectives: * determine the activity of cisplatin and etoposide in terms of response of patients with metastatic ewing's sarcoma or primitive neuroectodermal tumor. * assess the bone marrow and kidney toxicity of this regimen in these patients. outline: this is a multicenter study. patients receive cisplatin iv over 3 hours on days 1, 8, 15, 29, 36, and 43 and oral etoposide daily on days 1-15 and 29-43 in the absence of disease progression or unacceptable toxicity. projected accrual: a total of 21-45 patients will be accrued for this study within 2 years.

Eligibility criteria:
disease characteristics: * histologically confirmed ewing's family tumor as characterized by the following: * positive mic2 on immunohistochemistry or * evidence of a chromosomal translocation involving the ews gene by conventional cytogenetics * t(11; 22) translocation or variant or * demonstration of ews/fli1 or ews/erg gene fusion by pcr or fish * metastases outside the lung or pleura * at least 1 measurable lesion outside of previously irradiated area * no symptomatic or known cns metastases patient characteristics: age: * 15 to 65 performance status: * who 0-2 life expectancy: * not specified hematopoietic: * wbc at least 3,000/mm3 * neutrophil count at least 2,000/mm3 * platelet count at least 100,000/mm3 hepatic: * bilirubin less than 3 mg/dl * albumin greater than 2.5 g/dl renal: * creatinine less than 1.2 mg/dl * creatinine clearance greater than 70 ml/min cardiovascular: * no history of uncontrolled cardiovascular disease other: * no other severe medical illness, including psychosis * no other prior primary malignancy except adequately treated carcinoma in situ of the cervix or basal cell skin cancer * fertile patients must use effective contraception prior concurrent therapy: biologic therapy: * not specified chemotherapy: * no prior chemotherapy endocrine therapy: * not specified radiotherapy: * see disease characteristics surgery: * not specified

Keywords: metastatic ewing sarcoma/peripheral primitive neuroectodermal tumor
erector spinae plane block versus paravertebral block for analgesia after cardiac surgery (peps)

Conditions: Pain Syndrome; Analgesia; Anesthesia, Local

Summary: the purpose of this randomized double-blind study is to compare the analgesic efficacy of the bilateral erector spinae plane (esp) block versus the bilateral thoracic paravertebral block (tpvb), by ultrasound-guided single injection in patients who underwent sternotomy for cardiac surgery.

cardiac surgery causes moderate to severe postoperative pain during the first 24 - 48 post-operative hours. this pain is greatly increased by mobilization (respiratory physiotherapy) and leads to the consumption of morphine. appropriate analgesia, along with a reduction in morphine consumption are important factors in reducing morbidity after cardiac surgery and allow better postoperative rehabilitation. recently, the concept of multimodal analgesia has become established, which corresponds to ensuring optimal analgesia through the use of non-morphine drugs associated with locoregional analgesia. during cardiac surgery, paravertebral block (tpvb) technique is the first line of reference in our establishment. lately, a new approach of blocking the intercostal nerves called erector spinae plane block (esp) has been discovered. it is a technique that seems simpler and safer than tpvb. until now, the analgesic efficacy of the esp block compared to tpvb after cardiac surgery by sternotomy has never been studied.

Eligibility criteria:
inclusion criteria: * undergoing any (scheduled) surgery of the heart (valve or coronary surgery) via a median sternotomy * physical status classification (asa) ≤3 * patients benefiting from a social security scheme or benefiting from it through a third party exclusion criteria: * emergency cardiac surgery * exclusion criteria related to cardiac surgery with thoracotomy, occurrence of aortic dissection, redo surgery. * aortic counterpulsation * preoperative cardiogenic shock * lvef\< 30% * severe preoperative chronic or acute renal failure with creatinine clearance less than 30 ml / min according to the mdrd formula * pre-existing psychiatric pathology, including addiction to opioids * physical or intellectual incapacity to use a pca * known allergy or hypersensitivity to any of the study drugs or analgesia protocol (ropivacaine, paracetamol, opioids) * contraindication for performing the paravertebral block and erector of the spine (esp): infection at the site of injection, severe hemostasis disorder, thoracic spinal pathology making the procedure difficult or dangerous to operate * obese patient (bmi\> 30kg / m2) with poorly perceived thoracic spinous processes. * vulnerable patients(pregnant or breastfeeding women, persons benefiting from enhanced protection, namely persons deprived of their liberty by a judicial or administrative decision, adults under legal protection).

Keywords: cardiac surgery regional analgesia pain control
probabilistic risk modeling for disorder post traumatic stress (ptsd) after the attacks in paris in november 2015

Conditions: Stress Disorders, Post-Traumatic

Summary: the scientific approach of this project proposes to build a cohort of "psychological injuries" post-attack of 13 november 2015. this is called patients "involved", ie patients who directly witnessed the events and having the most either came under automatic gunfire or were close to an explosion, whether or not physically injured. the main objective is to define and validate a model of transition from acute stress disorder (asd) to posttraumatic stress disorder (ptsd) for better detection of the risk of unfavorable and thus better patient supported. the first step is to determine independent risk factors found in analytic prospective cohort study. bayesian models are well suited to exercise because they can integrate (i) the context related to the patient, (ii) the context related to the trauma itself, and (iii) the immediate reactions and long-term to the latter . they are particularly suited to understanding the brain disordered by saying down information (prior probability) wrong by improper memory of the traumatic event. the confrontation of these descending information and perceived bottom-information could be partly responsible for the symptoms of ptsd. once validated, the model will characterize the individual level the most at risk of unfavorable patients (calculating a probability of developing ptsd) and to assess the epidemiological impact on long-term cohort of event considered. these determinations are necessary prerequisites to optimize the means of support for these current and future casualties. the investigators main objective is to define a bayesian model describing a resilient functioning facing a trauma which also allows to describe a possible evolution of the asd to ptsd by an error. the state of ptsd or not will be determined by the pcl-s scale.

cohort tracking study

Eligibility criteria:
inclusion criteria: * patients who directly witnessed the events and having the most either came under automatic gunfire or were close to an explosion, whether or not physically injured exclusion criteria: * persons not physically present on the premises at the time of the attacks. * inability to understand or read french. * persons unable to express personal consent under whose major legal or private protection of liberty by judicial or administrative decision , or hospital emergency or without their consent
influence of oxygen on non-invasive measurement of hemoglobin

Conditions: Anesthesia

Summary: this study examines the effect of oxygen supplementation on the non-invasive measurement of hemoglobin.


Eligibility criteria:
inclusion criteria: * adult patients scheduled for a potentially hemorrhagic surgical procedure exclusion criteria: * anomaly (malformation, infection, swelling, irritation, ulceration, degenerative changes or significant edema) of the fingers, * tremors.

Keywords: hemoglobin determination oxygen
erectile dysfunction progression after percutaneous coronary angiography: is residual syntax score a predictive marker

Conditions: Coronary Arterial Disease (CAD); Erectile Dysfunction

Summary: participant information sheet dear participant, investigators would like to invite participants to participate in a research study and explain what it involves. please take a few moments to read the following information carefully. if you have any questions, feel free to ask us at any time. what is this study about? this study aims to understand how coronary angiography (a heart procedure you've recently had) may affect erectile function over time. investigators are especially interested in whether the degree of blockage in participants' heart vessels and how well participants were treated during the procedure affect erectile health. what will participants be asked to do? if participants agree to take part: investigators will ask participants to answer a short questionnaire with five questions about their erectile function. this will happen once while participants recover in the hospital and again 6 months later. each question is rated on a simple scale from 0 to 5. investigators will also collect some medical information, such as your age, weight, height, blood test results, details about your heart condition, other health problems, and the medications participants are taking. all information will be kept confidential and used only for scientific purposes. participants' identities will not be revealed in any part of the study. do participants have to take part? no. participation is completely voluntary. participants can choose not to take part, and you can also stop at any time without giving a reason. participants' decisions will not affect their medical care in any way. will there be any extra tests or costs? no. this study does not involve extra tests beyond regular medical care, such as blood tests or heart monitoring, and participation is free. how long will the study last? the study will last approximately one year. once it's completed, participants are welcome to ask for the results from our institution. who is conducting the study? the study is being conducted by: assist prof dr. timucin sipal (urology department) assist prof dr. caglar alp (cardiology department) you can contact them anytime using the phone number we have provided. what happens next? if participants are happy to participate, please sign the attached consent form. sincerely, the research team


Eligibility criteria:
inclusion criteria: * having a first heart attack exclusion criteria: * history of previous coronary intervention * neurological condition * previous pelvic surgery * aged less than 20 and more than 70 years * having an additional heart attack during the follow-up period * excluding from the study * having no sexual life

Keywords: syntax score residual syntax score erectile disfunction